The NHS is gone ...

DaisyAnne

This government wouldn't commit to the cost but I hope another party might Dickins. I just have to hang on to the thought that we can have a government for all the people after the last 12 years.

I think whatever care there is in the community we have to recognise some people will still have to be in hospital. If properly funded the idea is to keep out those who really don't need to be there so those that do can be treated.

Dealing with the staff shortages will not happen overnight. I cannot believe what this government has done to us and I don't envy Starmer and his team if they do get in. God knows what they will find. But none of that stops these being a good idea if properly carried out.

... I agree with everything you say.

We are desperately in need of a government that has the welfare of the country as a whole at its heart, one that shows some compassion for the impoverished and also encourages entrepreneurialism, achievement, etc. It shouldn't be that difficult for a party if it is committed to a more egalitarian nation - although undoing the damage brought about by years of Tory government is going to be a huge problem to begin unravelling.

I think people are without hope at the moment - we need a real sea-change. Other European countries are struggling, too, but I think we should still look at the models of countries like Norway, for example, which combines Capitalism with Social Welfare and invests in its people. Although of course, that country too is not without problems - but at least most of its citizens have hope for the future.

This government wouldn't commit to the cost but I hope another party might Dickins. I just have to hang on to the thought that we can have a government for all the people after the last 12 years.

I think whatever care there is in the community we have to recognise some people will still have to be in hospital. If properly funded the idea is to keep out those who really don't need to be there so those that do can be treated.

Dealing with the staff shortages will not happen overnight. I cannot believe what this government has done to us and I don't envy Starmer and his team if they do get in. God knows what they will find. But none of that stops these being a good idea if properly carried out.

MayBee70

I always remember that poor man who was killed by a schizophrenic soon after care in the community began. His wife ran some sort of campaign I believe. It’s still happening because people aren’t being cared for properly.

You are right, people are not being cared for to the level of care they actually need.

The man who my mother 'looked-after' was extremely disruptive and caused other residents a lot of anxiety and stress. I've no idea how dangerous he may have been, and my mother was certainly putting herself at risk. But what was the alternative? Basically, his doctor and those caring for him did very little other than to urge him to take his medication. According to my mother, he wasn't even happy most of the time to be in his home environment. Sometimes, CitC just isn't appropriate. And I don't think it worked at all for this poor man. If it hadn't been for my mother 'on-call', he would've been left entirely to his own devices - she did at least know how to deal with his outbursts having worked in a similar environment at one time.

I always remember that poor man who was killed by a schizophrenic soon after care in the community began. His wife ran some sort of campaign I believe. It’s still happening because people aren’t being cared for properly.

Hospitals at Home will be exactly like Care in the Community.

Both are good ideas - in principle - but they require a level of funding that the government is not prepared to commit to because the idea behind both is to save money.

My late mother, a retired SRN could've told you about Care-in-the-Community. She spent time every day responding to the distress (and the havoc it created) of a poor chap who was schizophrenic, who lived in the flat above hers. There just wasn't the staff nor the services in place to deal with him to any meaningful level.

Where are the services and staff for this project of Hospitals at Home - virtual wards - going to come from? There is a shortage of staff in just about every area of health care.

To go back to the article I quoted in the OP regarding our low number of beds, Denmark has only slightly more beds than us at 2.5 per 1,000 people. The difference, as they point out, is that it has fewer problems.

The writer describes the technology they use to monitor patient flow how many are on their way to A & E, how many are waiting there, and which wards have space available, meaning greater efficiency and better use of their decreased number of beds.

They quote Rory Deighton of the NHS Confederation, who says; The vision is right. The only way to deal with an ageing population is to help people to live independently, and in their own homes. The article concludes, But if you want more people out of hospital, you must also fund the alternatives. Noticeably, where Britain cut community nurses and practically abandoned the social care sector, the article tells us that the Danes have a long-term well-funded plan for elderly care.

It really isn't difficult to spot where we went wrong.

DaisyAnne

I may have been writing in my sleep, but I don't think I wrote about Hospitals at Home in the OP, although it was mentioned early on, Casdon.

Care in the community was someone making a comparison. Sadly, care in the community was grossly underfunded. Although this government may come up with good ideas - of which Hospitals at Home may be one - I think whatever they propose will still be grossly underfunded. It is the nature of these Conservatives.

I think I’ll leave you to it DaisyAnne, the figures quoted earlier on in the thread mainly refer to physical rather than mental health and learning disabilities, and I wasn’t specifically referring to you personally when I said there appeared to be confusion amongst posters between hospital at home style community care and Care in the Community - which isn’t surprising unless you have worked in the system. It’s not worth disagreeing over what is meant.

!

MayBee70

DaisyAnne

MayBee70

The latest The Rest is Politics Leading is an interview with Alan Milburn in which he discusses the problems he faced as health secretary and what he thinks needs to be done now. It’s very interesting.

There are some good political podcasts available, aren't there Maybee. So much better than watching/listening to a news broadcast that has one journalist commentating on what other journalists have said in newspapers.

I love TRIP’s. And I suddenly realised that I have Alastairs book ‘The Blair Years’ which I bought from a car boot sake years ago but never got round to reading because I thought it would be heavy going. I was hoping it might be a signed copy but it just says ‘To Dave from Liz’. I don’t think Dave ever read it.

So now we know what Truss got Cameron for Christmas

Yep!

I may have been writing in my sleep, but I don't think I wrote about Hospitals at Home in the OP, although it was mentioned early on, Casdon.

Care in the community was someone making a comparison. Sadly, care in the community was grossly underfunded. Although this government may come up with good ideas - of which Hospitals at Home may be one - I think whatever they propose will still be grossly underfunded. It is the nature of these Conservatives.

DaisyAnne

MayBee70

The latest The Rest is Politics Leading is an interview with Alan Milburn in which he discusses the problems he faced as health secretary and what he thinks needs to be done now. It’s very interesting.

There are some good political podcasts available, aren't there Maybee. So much better than watching/listening to a news broadcast that has one journalist commentating on what other journalists have said in newspapers.

I love TRIP’s. And I suddenly realised that I have Alastairs book ‘The Blair Years’ which I bought from a car boot sake years ago but never got round to reading because I thought it would be heavy going. I was hoping it might be a signed copy but it just says ‘To Dave from Liz’. I don’t think Dave ever read it.

Casdon

I’m getting confused. Are you all talking about Care in the Community, the policy for deinstitutionalisation, treating and caring for physically and mentally disabled people in their homes rather than in an institution, or are you talking about Hospital at Home, which is the initiative to look after people who would otherwise be in acute or community hospitals, which is where the thread originally started?
It all seems muddled to me, with some thinking Care in the Community is the same thing as Hospital at Home? The government’s initiative isn’t about the former as far as I can see.

I was just that the governments announcement about caring for people at home reminded me of when they closed down mental hospitals but then didn’t follow it through by providing care in the community. Which means I don’t believe a word that they say.

I’m getting confused. Are you all talking about Care in the Community, the policy for deinstitutionalisation, treating and caring for physically and mentally disabled people in their homes rather than in an institution, or are you talking about Hospital at Home, which is the initiative to look after people who would otherwise be in acute or community hospitals, which is where the thread originally started?
It all seems muddled to me, with some thinking Care in the Community is the same thing as Hospital at Home? The government’s initiative isn’t about the former as far as I can see.

MayBee70

The latest The Rest is Politics Leading is an interview with Alan Milburn in which he discusses the problems he faced as health secretary and what he thinks needs to be done now. It’s very interesting.

There are some good political podcasts available, aren't there Maybee. So much better than watching/listening to a news broadcast that has one journalist commentating on what other journalists have said in newspapers.

The latest The Rest is Politics Leading is an interview with Alan Milburn in which he discusses the problems he faced as health secretary and what he thinks needs to be done now. It’s very interesting.

Grantanow

Care in the community is all very well but what if it's contracted out to the lowest bidder. There is a letter in today's Telegraph recording the lethal consequences for one elderly woman discharged from hospital in a previous pilot scheme. When asylums were closed there were reports of patients simply being given train tickets to Brighton.

But it didn't have to be done that way. There was a big drive to sell of the buildings too - really do we expect anything else from the Conservatives? But do we expect the same from all other parties? I live in hope that they wouldn't behave like this.

Grantanow

Care in the community is all very well but what if it's contracted out to the lowest bidder. There is a letter in today's Telegraph recording the lethal consequences for one elderly woman discharged from hospital in a previous pilot scheme. When asylums were closed there were reports of patients simply being given train tickets to Brighton.

..and that's the problem. The principle may be good but we know it will be implemented in the most shoddy way possible with the main driver being saving money, not patient care.

Care in the community is all very well but what if it's contracted out to the lowest bidder. There is a letter in today's Telegraph recording the lethal consequences for one elderly woman discharged from hospital in a previous pilot scheme. When asylums were closed there were reports of patients simply being given train tickets to Brighton.

I didn’t say that care in the community was a bad idea. I just meant that the Conservatives used it as an excuse to throw people out onto the streets and had no intention of providing the care in the community that was promised. From memory I think it was based on what had been done in Sweden, the difference being that they did actually provide the support that was needed.

If you keep making up the other side of your argument and putting my name to it Maizie I will call you out when you do it.

So, where did I say anything about "affordability"? The lack of money both for the staff and infrastructure in the public systems that is the problem. This is down to this government starving the public services for the last 12 years. I cannot imagine how many times I have said that.

I did not mention matrons, so more of your imagined disagreement. The comment about asylums was in reply to Maybee's comment about care in the community, which I believe was a good idea, having seen what went before it. As I said, the problem was it was badly underfunded. It was nothing to do with anything you said. My replies are not all about you.

You are making up things simply to give yourself something to oppose but I did not write these things. Nor have I, at any time, suggested that was the case. Doing this can only be because either you have a problem with your eyesight (in which case you have my sympathies) or you have no substantive argument with my views but are determined to magic one up.

It is the staffing and the lack of money both for the staff and infrastructure in the public systems that is the problem.

It is deliberately sustained cutting of funding that is the initial problem, DaisyAnne. That is a political choice, nothing to do with 'affordability'.

And there's no need to talk down to me as though I was calling for a return to hospital matrons and 'asylums'.

Hospital at home isn’t new, it’s been running with varying degrees of success for several decades in the UK now. It is definitely what the majority of patients want (not all, and definitely not the families of all). The biggest issue is that to do it well is more expensive, more risky for the patient, and more labour intensive than keeping older people in hospital. You need a night service as well as a daytime service, and on call staff for urgent issues. It uses more ambulance time because it’s not always successful and people can be in and out of hospital frequently. To run well needs a lot of well trained staff and joined up working. It can be great, but it’s not by any stretch of the imagination a quick fix,

MaizieD

There's no reason at all why hospitals couldn't be run as they were in the past, DaisyAnne. That is to say, as they were run in the past when they worked. Their problems now are mainly caused by relentless and massive underfunding over the past 12 years. That and poor planning for training staff. And Brexit causing an exodus of EU personnel with none to replace them.
And some ridiculous reorganisations.

There is, equally, no reason why running them as they were run in the past is a good thing. Surely, doing the best for the time we live in is what we need and we have to be open-minded to work out what that is.

The idea of Care in the Community was a good one. I don't know if you ever visited an old mental health establishment in the 1980s before the law changed. The practice in many was old-fashioned to a dangerous degree for some, and there was still a stigma around mental health issues. Many of those in asylums should never have been there but out of the community things could happen that we wouldn't allow now. And, of course, they had been left short of money, and the National Health estate had been run down.

Again, it is worth looking at the idea the tweet picked up. Communities are the best place for most people. There was a woman who had been treated in this way on The World at One. It's worth listening to.

We all know the problem cannot be solved by either extreme ideology. It is the staffing and the lack of money both for the staff and infrastructure in the public systems that is the problem. It is also the lack of monitoring and a feeling that there should be no constraints which affects some in the private system. We can run a private, and a public system, alongside each other with each learning from the other if our perspective is from the centre and not one or other extreme.

Hear hear.